Cannabis Use Disorder Didn't Worsen Heart Surgery Outcomes
Patients with cannabis use disorder who underwent heart surgery had similar in-hospital outcomes to matched controls — but they were far more likely to also use tobacco, opioids, cocaine, and alcohol.
Quick Facts
What This Study Found
Analyzing 846,837 cardiovascular surgery patients from a national database, researchers identified 11,724 (1.4%) with a cannabis use disorder diagnosis. After carefully matching these patients to controls with similar baseline characteristics and comorbidities, cannabis use disorder was not associated with additional in-hospital complications or death.
However, the data revealed something else: patients with cannabis use disorder had dramatically higher rates of polysubstance use. They were significantly more likely to also smoke tobacco, abuse opioids, use cocaine or stimulants, and abuse alcohol compared to matched controls. These co-occurring substance use patterns were the dominant clinical feature of the CUD population.
Specific complications like pneumonia (13% vs. 9.4%) were higher in the CUD group, but the researchers attributed these differences to the polysubstance use profile rather than cannabis itself.
Key Numbers
846,837 total cardiovascular surgery patients. 11,724 (1.4%) with CUD. Pneumonia: 13% CUD vs. 9.4% controls. Significantly higher rates of co-occurring tobacco, opioid, cocaine/stimulant, and alcohol use in CUD patients. No significant difference in in-hospital mortality after matching.
How They Did This
Retrospective observational study using the Nationwide Readmissions Database (2016–2018). Identified 846,837 cardiovascular surgery patients, 11,724 with CUD diagnosis. Used 1:1 balancing-score matching to control for baseline characteristics and comorbidities when comparing outcomes.
Why This Research Matters
For the growing number of patients who use cannabis and need cardiac surgery, this study provides reassurance that cannabis use disorder alone doesn't appear to worsen surgical outcomes. But it also highlights that CUD rarely exists in isolation — the polysubstance use patterns that accompany it are what clinicians should be screening for and managing in the surgical setting.
The Bigger Picture
This adds to the cardiovascular cannabis evidence (connecting to RTHC-00167 on adolescent cardiac complications and RTHC-00178 on cannabis and cardiovascular health) by examining surgical outcomes specifically. The finding that CUD is a marker for polysubstance use rather than an independent surgical risk factor is clinically actionable — it suggests the clinical conversation should focus on the full substance use picture rather than cannabis in isolation.
What This Study Doesn't Tell Us
Retrospective database study relying on ICD codes for CUD diagnosis — likely underestimates true cannabis use since many users don't receive a formal CUD diagnosis. Cannot distinguish between active use and historical use at the time of surgery. The 2016–2018 data predates recent increases in cannabis potency and use. In-hospital outcomes only — doesn't capture post-discharge complications.
Questions This Raises
- ?Would active THC use at the time of surgery (vs. a historical CUD diagnosis) produce different outcomes?
- ?Does the method of cannabis consumption (smoking vs. edibles) affect perioperative risk?
- ?How should cardiac surgery teams incorporate cannabis use screening into preoperative assessment?
Trust & Context
- Key Stat:
- Evidence Grade:
- Large observational study with careful matching from a national database — provides good real-world evidence but cannot fully control for all confounders, particularly unmeasured polysubstance effects.
- Study Age:
- Published in 2026 using 2016–2018 data. Cannabis use patterns and potency have shifted since the data collection period.
- Original Title:
- Nationwide outcomes of cardiac surgery in patients with cannabis use disorder.
- Published In:
- Journal of cardiothoracic surgery, 21(1) (2026) — The Journal of Cardiothoracic Surgery is a peer-reviewed journal focusing on research in the field of cardiothoracic surgery.
- Authors:
- Dewan, Krish C, Mahboubi, Rashed, Xu, Samantha, Maigrot, Jean-Luc A, An, Crystal, Zhou, Guangjin, Ferre, Jose L Diz, Koroukian, Siran M, Weiss, Aaron J, Soltesz, Edward G
- Database ID:
- RTHC-08224
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Read More on RethinkTHC
- cannabis-dependence-physical-psychological-addiction-science
- cannabis-perception-vs-evidence-gap
- cannabis-use-disorder-test
- cross-addiction-quit-weed-start-drinking
- is-weed-addictive
- is-weed-addictive-science
- quitting-weed-and-alcohol
- rehab-for-weed-addiction-necessary
- signs-of-cannabis-use-disorder
- weed-vape-pen-addiction
- why-does-weed-make-heart-race-cardiovascular
- thc-and-blood-pressure-medication-interactions
Cite This Study
https://rethinkthc.com/research/RTHC-08224APA
Dewan, Krish C; Mahboubi, Rashed; Xu, Samantha; Maigrot, Jean-Luc A; An, Crystal; Zhou, Guangjin; Ferre, Jose L Diz; Koroukian, Siran M; Weiss, Aaron J; Soltesz, Edward G. (2026). Nationwide outcomes of cardiac surgery in patients with cannabis use disorder.. Journal of cardiothoracic surgery, 21(1). https://doi.org/10.1186/s13019-025-03755-6
MLA
Dewan, Krish C, et al. "Nationwide outcomes of cardiac surgery in patients with cannabis use disorder.." Journal of cardiothoracic surgery, 2026. https://doi.org/10.1186/s13019-025-03755-6
RethinkTHC
RethinkTHC Research Database. "Nationwide outcomes of cardiac surgery in patients with cann..." RTHC-08224. Retrieved from https://rethinkthc.com/research/dewan-2026-nationwide-outcomes-of-cardiac
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.